Outcome of mechanical ventilation in patients of Guillain-Barre syndrome: An audit from a tertiary care centre

Abstract

Background: About a third of patients with Guillain-Barre Syndrome (GBS) presents with acute respiratory failure requiring invasive mechanical ventilation. We studied the outcome of patients with GBS. Material and Methods: A retrospective data extraction was done on clinical records of 103 patients with diagnosis of GBS admitted in intensive care unit (ICU) over a period of 7 years. All patients requiring ICU admission and mechanical ventilation for more than 48 h were included in the study. Demographic profile, clinical characteristics, treatment given, duration of mechanical ventilation, ICU acquired infections, incidence of pressure sores, and length of ICU stay was noted. Results: Eighty six patients fulfilled the inclusion criteria. The mean age of patients was 32.4 (± 18.12) years. Mean duration of ICU stay was 28.9 (± 26.99) days. Majority (82%) of our patients were male. The most common co-morbidities were diabetes mellitus and hypertension. Axonal neuropathy was the most common (76%) lesion. Autonomic dysfunction was present in 35% of patients. Fifty two percent of patients received immunoglobulin therapy while 64% of required mechanical ventilation for more than 14 days. Tracheostomy was performed in 85% of patients. Ventilator associated pneumonia (VAP) was seen in 33% of patients, blood stream infection in 11% and urinary tract infection in 7%. Forty percent of patients developed bed sore grade 1-2. Seven (8.3%) patients died perhaps due to complications including VAP and sepsis. Conclusions: GBS has a good outcome despite prolonged mechanical ventilation and ICU stay.

Keywords

• Guillain-Barre syndrome
• mechanical ventilation intensive care unit
• pneumonia
• sepsis